Table 3.
Total gestational weight change in pre-pregnancy body mass index specific quintiles and the association with cardiovascular and diabetes cause specific mortality, stratified by pre-pregnancy body mass index (n=46,042).
| Total Gestational Weight Changea | |||||
|---|---|---|---|---|---|
| Quintile 1 | Quintile 2 | Quintile 3 | Quintile 4 | Quintile 5 | |
| Pre-pregnancy BMI Status (kg/m 2 ) | Cardiovascular Disease Mortality | ||||
| < 18·5 kg/m 2 | |||||
| Mortality rate per 1000 person years (95% CI)b | 1·8 (1·4, 2·2) | 1·7 (1·4, 2·2) | 1·7 (1·4, 2·1) | 1·5 (1·1, 1·9) | 1·4 (1·0, 1·8) |
| Unadjusted HR (95% CI) | 1·09 (0·78, 1·53) | 1·09 (0·78, 1·52) | 1 (Reference) | 0·89 (0·61, 1·30) | 0·97 (0·65, 1·43) |
| Adjusted HR (95% CI)c | 1·01 (0·70, 1·44) | 1·08 (0·78, 1·51) | 1 (Reference) | 0·93 (0·63, 1·37) | 1·09 (0·74, 1·61) |
| 18·5 – 24·9 kg/m 2 | |||||
| Mortality rate per 1000 person years (95% CI)b | 2·4 (2·2, 2·5) | 1·9 (1·7, 2·0) | 1·9 (1·7, 2) | 2·1 (1·9, 2·3) | 2·2 (2·0, 2·4) |
| Unadjusted HR (95% CI) | 1·24 (1·11, 1·39) | 0·96 (0·85, 1·09) | 1 (Reference) | 1·07 (0·94, 1·22) | 1·14 (1·01, 1·30) |
| Adjusted HR (95% CI)c | 1·07 (0·95, 1·20) | 0·91 (0·81, 1·03) | 1 (Reference) | 1·08 (0·95, 1·22) | 1·15 (1·01, 1·30) |
| 25·0 – 29·9 kg/m 2 | |||||
| Mortality rate per 1000 person years (95% CI)b | 4·0 (3·6, 4·5) | 3·6 (3·2, 4·1) | 3·3 (2·9, 3·7) | 3·2 (2·8, 3·7) | 3·7 (3·2, 4·1) |
| Unadjusted HR (95% CI) | 1·19 (0·99, 1·43) | 1·12 (0·91, 1·38) | 1 (Reference) | 0·89 (0·71, 1·13) | 1·12 (0·92, 1·36) |
| Adjusted HR (95% CI)c | 1·10 (0·91, 1·33) | 1·13 (0·91, 1·39) | 1 (Reference) | 0·97 (0·77, 1·21) | 1·24 (1·01, 1·52) |
| ≥ 30·0 kg/m 2 | |||||
| Mortality rate per 1000 person years (95% CI)b | 5·8 (4·9, 6·7) | 5·9 (5·1, 7) | 4·9 (4·2, 5·8) | 5·6 (4·8, 6·6) | 5·1 (4·2, 6·0) |
| Unadjusted HR (95% CI) | 1·21 (0·95, 1·55) | 1·27 (1·00, 1·63) | 1 (Reference) | 1·08 (0·83, 1·40) | 1·05 (0·82, 1·36) |
| Adjusted HR (95% CI)c | 1·10 (0·85, 1·43) | 1·18 (0·91, 1·52) | 1 (Reference) | 1·11 (0·85, 1·45) | 1·08 (0·83, 1·41) |
| Pre-pregnancy BMI Status | Diabetes Mortality | ||||
| < 18·5 kg/m 2 | |||||
| Mortality rate per 1000 person years (95% CI)b | 0·1 (0·1, 0·3) | 0·2 (0·1, 0·4) | 0·1 (0·1, 0·3) | 0·2 (0·1, 0·4) | 0·3 (0·2, 0·5) |
| Unadjusted HR (95% CI) | 1·45 (0·44, 4·75) | 1·89 (0·66, 5·44) | 1 (Reference) | 0·89 (0·20, 3·99) | 1·83 (0·64, 5·19) |
| Adjusted HR (95% CI)c | 1·23 (0·33, 4·57) | 2·36 (0·70, 7·96) | 1 (Reference) | 1·19 (0·24, 5·96) | 2·54 (0·76, 8·43) |
| 18·5 – 24·9 kg/m 2 | |||||
| Mortality rate per 1000 person years (95% CI)b | 0·3 (0·2, 0·4) | 0·2 (0·2, 0·3) | 0·3 (0·2, 0·3) | 0·3 (0·3, 0·4) | 0·3 (0·3, 0·4) |
| Unadjusted HR (95% CI) | 1·27 (0·86, 1·87) | 1·02 (0·68, 1·52) | 1 (Reference) | 1·40 (0·97, 2·02) | 1·56 (1·10, 2·23) |
| Adjusted HR (95% CI)c | 0·95 (0·62, 1·44) | 0·91 (0·62, 1·34) | 1 (Reference) | 1·46 (0·98, 2·16) | 1·63 (1·13, 2·35) |
| 25·0 – 29·9 kg/m 2 | |||||
| Mortality rate per 1000 person years (95% CI)b | 0·4 (0·3, 0·6) | 0·8 (0·6, 1·1) | 0·4 (0·3, 0·6) | 0·6 (0·4, 0·8) | 1·0 (0·7, 1·2) |
| Unadjusted HR (95% CI) | 1·01 (0·61, 1·67) | 1·65 (0·98, 2·77) | 1 (Reference) | 1·33 (0·81, 2·18) | 2·09 (1·33, 3·28) |
| Adjusted HR (95% CI)c | 0·87 (0·52, 1·47) | 1·68 (1·00, 2·81) | 1 (Reference) | 1·44 (0·87, 2·38) | 2·24 (1·41, 3·55) |
| ≥ 30·0 kg/m 2 | |||||
| Mortality rate per 1000 person years (95% CI)b | 1·5 (1·1, 2·1) | 1·3 (0·9, 1·8) | 1·4 (1·0, 1·9) | 1·3 (0·9, 1·8) | 1·7 (1·3, 2·3) |
| Unadjusted HR (95% CI) | 1·02 (0·65, 1·60) | 0·86 (0·53, 1·41) | 1 (Reference) | 0·93 (0·56, 1·56) | 1·11 (0·70, 1·75) |
| Adjusted HR (95% CI)c | 0·90 (0·57, 1·44) | 0·78 (0·47, 1·30) | 1 (Reference) | 0·93 (0·55, 1·58) | 1·10 (0·68, 1·79) |
Abbreviations: BMI, body mass index; CI, confidence interval; HR, hazard ratio.
Quintiles of gestational weight change were defined within each pre-pregnancy BMI category.
Mortality rate estimated obtained from a single imputed dataset.
Analyses adjusted for the following index pregnancy variables: age, smoking, race/ethnicity, parity, marital status, income, education, preexisting diabetes, preexisting cardiovascular conditions, preexisting cancer/tumors, preexisting neurological conditions, preexisting renal conditions, preexisting respiratory conditions, prior pregnancy loss, site, study year, pre-pregnancy body mass index, gestational week at delivery.